Y83-84573-49961 · OpenVSafe

Timeline

Registration Vaccinations Survey responses Call reports Cases without a report Call attempts Call successful Pregnancy survey

2021-03-08
Registered in v-safe
2021-03-08
Dose 1 — Moderna
2021-03-08
Survey response — day 0, dose 1
MedDRA: Dysgeusia, Ear pruritus, Immediate post-injection reaction, Medical observation, Pruritus, Self-medication — Feeling: Good · Site: Pain · Fatigue or tiredness · Be unable to do your normal daily activities

Free text: mouth felt similar to "freshly brushed teeth, minty-fresh" but wouldn't classify as tingling about 10 minutes post injection. Stayed in observation for 30 minutes. Ended around 1 1/2 hrs. post injection, but face and ears became itchy. Took 50 mg Benadryl per RN at vax clinic still; slightly itchy 2 1/2 hrs. after Benadryl.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-09
Survey response — days 1–6 daily, dose 1
MedDRA: Pruritus, Self-medication — Feeling: Good · Site: Pain

Free text: Still itchy but no Benadryl today.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-11
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-03-12
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-13
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-16
Health check-in — day 7, dose 1
Feeling: Fair · Fever · Chills, Fatigue or tiredness

Adult check-in
2021-03-22
Health check-in — day 14, dose 1
Feeling: Fair

Adult check-in
2022-03-08
Survey response — 12 months, dose 1
MedDRA: Alopecia, Fatigue, Migraine, Myalgia, Rash — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Hair loss Rash Muscle aches and fatigue Migraines

MedDRA releases: 2024-11 · check-in free text available
2022-03-08
Report sent to call center — 12 months, dose 1
Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2022-03-10
Call successful
Participant prefers to complete VAERS report online

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-08	Moderna

Call center

Reported	Outcome	VAERS-related outcome
2022-03-08	Successful 2022-03-10	Participant prefers to complete VAERS report online

Free text

Release 5 — day 0, dose 1

2021-03-08

Systemic reaction (other): mouth felt similar to "freshly brushed teeth, minty-fresh" but wouldn't classify as tingling about 10 minutes post injection. Stayed in observation for 30 minutes. Ended around 1 1/2 hrs. post injection, but face and ears became itchy. Took 50 mg Benadryl per RN at vax clinic still; slightly itchy 2 1/2 hrs. after Benadryl.

Release 5 — days 1–6 daily, dose 1

2021-03-09

Systemic reaction (other): Still itchy but no Benadryl today.

Release 11 — 12 months, dose 1

2022-03-08

Symptoms: Hair loss Rash Muscle aches and fatigue Migraines

Each entry is dated by the survey it was written in (the CDC re-sent the releases with survey dates in 2025); click a date to see that survey response. The CDC cut some text off at about 250 characters: symptoms in every release, and the other two fields in releases 9-12. Those entries are marked "cut off by CDC".

MedDRA terms by release

Field	Preferred term	2021-09	2023-04	2024-11
SD	Alopecia	·	·	✓
SD	Fatigue	·	·	✓
SD	Migraine	·	·	✓
SD	Myalgia	·	·	✓
SD	Rash	·	·	✓
SRO	Dysgeusia	✓	✓	✓
SRO	Ear pruritus	✓	✓	✓
SRO	Immediate post-injection reaction	✓	✓	✓
SRO	Medical observation	✓	✓	✓
SRO	Pruritus	✓	✓	✓
SRO	Self-medication	✓	✓	✓

✓ active code · ○ coded but marked inactive · blank = not in that release